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More education needed on lifestyle change
More education programs are needed to halt the rise in Type II diabetes in children, which increases the risk of mortality at an early age. If children developed healthy eating habits and exercised more, they could prevent the development of the disease in childhood, according to experts.
At the diabetes center at Children's Hospital of Philadelphia, clinicians are seeing one to two patients diagnosed with Type II diabetes a month, which is about triple the number they saw even a year ago, says Nicole Celona-Jacobs, MS, RD, CDE, a clinical nutritionist at the center.
The sharp increase throughout the nation is attributed to obesity. Out of approximately 100 cases of Type II diabetes being treated at the center, 90% of the children are overweight and 75% are obese.
Risk factors include obesity, family history, and age, says Anita Powell, RN, BSN, CDE, a diabetes educator at Saint Joseph's Hospital of Atlanta. Therefore, obesity seems to be the trigger for children who have a family history of Type II diabetes. In the diabetes center at Saint Joseph's, adolescents in the 200- to 300-pound range are coming in for treatment of diabetes.
The American diet is a major cause of obesity. Families are eating more meals at fast food restaurants and purchasing convenience foods at grocery stores such as frozen dinners and prepackaged lunches. A second factor is a sedentary lifestyle. A survey conducted by the U.S. Surgeon General in 1992 found that half of all American youth ages 12-21 were not vigorously active on a regular basis. Rather than participating in recreational activities, children are more likely to play video games, work at the computer, or watch television.
Behavior change is difficult, says Celona-Jacobs. The U.S. Surgeon General recommends 30 minutes of moderate to intense activity daily. When parents learn this, most are shocked, she says. Therefore, educators at Children's Hospital of Philadelphia often begin by trying to get patients to cut back on the amount of time spent in sedentary activity. For example, kids could spend one hour watching television after school, and the rest of the time before dinner doing an activity where they move around.
Change is difficult. The diabetes center at Children's Hospital tried offering free memberships to the local YMCA, but not many families took advantage of the offer. Their advice on what types of food to purchase and serve often goes unheeded as well. Part of the problem is that supermarkets are not easily accessible in some Philadelphia neighborhoods.
"The bottom line is changing beliefs and attitudes. We find that the more family support the children have, the more successful they are," says Celona-Jacobs. By simply losing 20 pounds, a child could improve his or her blood sugar levels.
Once a child develops Type II diabetes, learning to control blood glucose levels is very important. "High blood sugar levels over time can lead to complications," says Powell. Complications might include eye problems, blindness, and increased risk for heart attacks.
To help prevent obesity in children, Celona-Jacobs recommends that pediatricians take a good weight assessment and family history. "When children are at risk, try to educate families about the danger of obesity. It is a matter of changing their attitude," she explains.
For more information on prevention of Type II diabetes in children, contact:
• Nicole Celona-Jacobs, MS, RD, CDE, Clinical Nutritionist, Children's Hospital of Philadelphia, Diabetes Center for Children, 32 Fourth St. and Civic Center Blvd., Philadelphia, PA 19104. Telephone: (215) 590-3174. Fax: (215) 590-3053. E-mail: firstname.lastname@example.org.